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1 Impact of heterogeneity on identifying sources of human infection Surveys have demonstrated a great deal of heterogeneity amongst environmental isolates of M. avium and M. intracellulare (Frothingham & Wilson 1993, 1994). As a consequence of the high frequency of M. avium infection in AIDS patients (Horsburgh 1991) there was a great deal of interest in identifying the source of M. avium. This led to the development of methods for fingerprinting M. avium, culminating in the identification of M.
The final issue of importance is the development of effective disinfection strategies for reduction of M. avium in the environment. Below is a list of methodological research issues: • improve recovery or detection of M. avium in environmental samples • define M. avium and its various types • identify markers for M. avium virulence • identify the dose-response to M. avium infection in different human hosts • develop effective M. avium disinfection strategies. Current methods for recovery of M. avium from environmental samples are limited by losses due to transfer, adherence and decontamination.
Avium on the available nutrients. This phenomenon is probably responsible for the growth of M. avium in drinking-water distribution systems (Falkinham et al. 2001) and its presence in hot tubs and spas (Embil et al. 1997). The high hydrophobicity of M. avium leads to its adherence to surfaces. That, coupled with its resistance to heavy metals, means that it may be a pioneer of biofilm formation on metals. The ability of M. avium to grow at low oxygen levels means that in spite of the reduced oxygen concentration in biofilms (Stewart 1994) M.
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